Q.1 Which of the following is the most common cause of optic neuritis in adults?
Glaucoma
Multiple sclerosis
Diabetic retinopathy
Hypertensive retinopathy
Explanation - Optic neuritis in adults is most commonly associated with multiple sclerosis, often presenting with sudden vision loss and pain on eye movement.
Correct answer is: Multiple sclerosis
Q.2 A pale optic disc on fundus examination suggests which condition?
Papilledema
Optic atrophy
Optic neuritis
Retinitis pigmentosa
Explanation - Optic atrophy is characterized by pallor of the optic disc due to loss of optic nerve fibers, often from chronic damage.
Correct answer is: Optic atrophy
Q.3 Which visual field defect is most typical in glaucoma affecting the optic nerve?
Central scotoma
Bitemporal hemianopia
Arcuate scotoma
Quadrantic anopia
Explanation - Glaucoma initially causes arcuate scotomas due to loss of nerve fibers in the optic nerve head, progressing from peripheral to central vision loss.
Correct answer is: Arcuate scotoma
Q.4 Leber's hereditary optic neuropathy primarily affects which demographic?
Middle-aged women
Young men
Children under 10
Elderly men
Explanation - Leber's hereditary optic neuropathy is a mitochondrial genetic disorder that predominantly affects young adult men, causing sudden central vision loss.
Correct answer is: Young men
Q.5 Which test is most sensitive for detecting early optic nerve dysfunction?
Fundus photography
Visual evoked potentials
Slit-lamp examination
Tonometry
Explanation - Visual evoked potentials (VEP) measure electrical responses of the brain to visual stimuli and are sensitive for early optic nerve dysfunction before structural changes appear.
Correct answer is: Visual evoked potentials
Q.6 Papilledema is usually caused by:
Optic nerve inflammation
Increased intracranial pressure
Ischemic optic neuropathy
Glaucomatous damage
Explanation - Papilledema refers to optic disc swelling due to raised intracranial pressure, often bilateral and associated with headaches or nausea.
Correct answer is: Increased intracranial pressure
Q.7 Which condition is associated with a relative afferent pupillary defect (RAPD)?
Bilateral cataracts
Unilateral optic neuritis
Macular degeneration
Keratoconjunctivitis
Explanation - RAPD occurs when there is asymmetric optic nerve function, commonly seen in unilateral optic neuritis or optic nerve compression.
Correct answer is: Unilateral optic neuritis
Q.8 Anterior ischemic optic neuropathy (AION) is most often associated with:
Giant cell arteritis
Diabetes insipidus
Thyroid eye disease
Retinal detachment
Explanation - AION can result from compromised blood flow to the optic nerve head. In older adults, giant cell arteritis is a common cause requiring urgent treatment.
Correct answer is: Giant cell arteritis
Q.9 Which visual field defect is classic for chiasmal lesions?
Central scotoma
Bitemporal hemianopia
Altitudinal defect
Peripheral constriction
Explanation - Lesions at the optic chiasm, often due to pituitary tumors, compress crossing fibers leading to loss of temporal visual fields in both eyes.
Correct answer is: Bitemporal hemianopia
Q.10 Optic nerve head drusen are primarily:
Vascular malformations
Calcified deposits
Inflammatory lesions
Neoplastic growths
Explanation - Optic nerve head drusen are hyaline-like calcified deposits within the optic nerve head, often asymptomatic but may cause visual field defects.
Correct answer is: Calcified deposits
Q.11 Which symptom is most characteristic of acute optic neuritis?
Gradual painless vision loss
Sudden painless vision loss
Pain with eye movement
Bilateral visual field constriction
Explanation - Acute optic neuritis usually presents with subacute vision loss and periocular pain, especially on eye movement, often unilateral.
Correct answer is: Pain with eye movement
Q.12 Which imaging modality is preferred for evaluating compressive optic neuropathies?
Optical coherence tomography (OCT)
MRI of the orbit and brain
X-ray of the skull
Ultrasound B-scan
Explanation - MRI provides detailed soft tissue imaging to detect tumors, aneurysms, or other lesions compressing the optic nerve.
Correct answer is: MRI of the orbit and brain
Q.13 Color vision defects are most commonly associated with:
Macular degeneration
Optic nerve disorders
Cataracts
Keratitis
Explanation - Optic nerve diseases, such as optic neuritis or hereditary optic neuropathies, often affect red-green color perception.
Correct answer is: Optic nerve disorders
Q.14 Which condition often causes optic disc swelling without visual loss initially?
Papilledema
Anterior ischemic optic neuropathy
Optic neuritis
Glaucoma
Explanation - Papilledema is optic disc swelling due to raised intracranial pressure and can initially be asymptomatic regarding vision.
Correct answer is: Papilledema
Q.15 Which optic nerve disorder is commonly bilateral in presentation?
Leber's hereditary optic neuropathy
Anterior ischemic optic neuropathy
Optic neuritis due to MS
Compressive optic neuropathy
Explanation - Leber's hereditary optic neuropathy usually presents with subacute, painless central vision loss in both eyes sequentially or simultaneously.
Correct answer is: Leber's hereditary optic neuropathy
Q.16 Temporal pallor of the optic disc indicates:
Chronic glaucoma
Papilledema
Acute optic neuritis
Retinal detachment
Explanation - Chronic glaucomatous optic neuropathy causes cupping and temporal pallor due to selective loss of retinal ganglion cells.
Correct answer is: Chronic glaucoma
Q.17 A sudden, painless monocular vision loss in a patient over 60 is most likely due to:
Anterior ischemic optic neuropathy
Optic neuritis
Papilledema
Glaucoma attack
Explanation - In older adults, sudden painless monocular vision loss is most often from AION due to vascular insufficiency of the optic nerve head.
Correct answer is: Anterior ischemic optic neuropathy
Q.18 Which finding is characteristic of optic disc edema due to increased intracranial pressure?
Disc cupping
Blurring of disc margins
Pale disc
Cherry-red spot
Explanation - Papilledema presents as swelling of the optic disc with blurred margins and often engorged vessels due to increased intracranial pressure.
Correct answer is: Blurring of disc margins
Q.19 Which hereditary optic neuropathy is associated with mitochondrial DNA mutations?
Leber's hereditary optic neuropathy
Dominant optic atrophy
Kjer's optic atrophy
Optic neuritis
Explanation - Leber's hereditary optic neuropathy (LHON) is a mitochondrial disorder causing bilateral central vision loss, primarily in young men.
Correct answer is: Leber's hereditary optic neuropathy
Q.20 Optic nerve head drusen can mimic which condition on fundus examination?
Papilledema
Glaucomatous cupping
Optic neuritis
Retinal detachment
Explanation - Superficial optic nerve head drusen may appear as disc swelling, mimicking papilledema, but without true increased intracranial pressure.
Correct answer is: Papilledema
Q.21 Which of the following is a risk factor for ischemic optic neuropathy?
Hypertension
Myopia
Hyperopia
Astigmatism
Explanation - Vascular risk factors such as hypertension, diabetes, and atherosclerosis increase the likelihood of ischemic optic neuropathy.
Correct answer is: Hypertension
Q.22 A relative afferent pupillary defect indicates:
Optic nerve dysfunction
Lens opacity
Retinal detachment
Macular degeneration
Explanation - RAPD is a hallmark of asymmetric optic nerve or severe retinal disease, indicating impaired transmission of light signals.
Correct answer is: Optic nerve dysfunction
Q.23 Bitemporal hemianopia usually results from a lesion at the:
Optic chiasm
Optic tract
Optic nerve head
Lateral geniculate nucleus
Explanation - Lesions at the central optic chiasm typically compress crossing nasal fibers, leading to loss of temporal visual fields in both eyes.
Correct answer is: Optic chiasm
Q.24 Which condition can present with swollen optic discs and transient visual obscurations?
Papilledema
Optic neuritis
Anterior ischemic optic neuropathy
Glaucoma
Explanation - Papilledema from raised intracranial pressure may cause transient visual obscurations, which are brief episodes of vision loss or dimming.
Correct answer is: Papilledema
Q.25 Temporal pallor of the optic disc is often seen in:
Chronic glaucoma
Acute optic neuritis
Papilledema
Retinitis pigmentosa
Explanation - Chronic glaucoma leads to selective loss of retinal ganglion cell axons, resulting in temporal pallor and cupping of the optic disc.
Correct answer is: Chronic glaucoma